Physiotherapists in Grays treat many different conditions including the issues profiled below.

Muscle

Human muscle is classified into three types, smooth, striated and cardiac. Striated or skeletal muscle is the type we think about when we consider muscle, allowing us to contract with force, maintain posture and produce movement. Muscle is well supplied with blood and also with nerve endings which are able to continuously monitor the stresses and strains through the tissue. Pain nerve endings are present mainly in the fibrous sheaths which surround the muscle. The muscle is structured in bundles of fibres, each surrounded by a fibrous sheath which join together at the ends into tendinous tissue on its way to attachment to bone.

Muscle fibres can be orientated in various directions which gives the muscles different abilities as contractile structures. If the fibres are arranged longitudinally along the muscle it tends to be longer and to be able to contract more in length terms, while muscles in different configurations such as the fibres on a feather can generate higher degrees of force. Higher forces may be required in muscles which have to work against gravity and move the weight of the body. Muscles have three different types of fibres, named Type 1, 2A and 2B, with different functions.

Tendon-Bone and Ligament-Bone Conditions . Mechanical Factors

Problems with the junctions between bone and ligaments or tendons can occur because of mechanical rather than inflammatory factors, with overuse injuries, trauma and sport examples of causative factors. MRI scanning may show a pathological change in the insertion or enthesis but the differences between changes caused by inflammation and mechanical factors is not great. It is fairly clear at the Achilles tendon as changes caused by mechanical factors occur two to six centimetres above the insertion while inflammatory changes will occur at the insertion itself. Degenerative changes in the insertions may give similar effects to the changes from inflammation.

Enthesis in osteoarthritis may show the same, if more limited, changes which occur in inflammatory conditions. Modern investigations have improved our knowledge of these conditions, with spinal problems best imaged by magnetic resonance imaging (MRI) and areas of the body which are more easily reached can better be checked out using ultrasound. Swelling of the bony areas around the insertion can be present on scanning, as is soft tissue swelling of the enthesis and its surrounding region. However, a normal MRI and a negative blood test do not exclude an inflammatory arthritis as both tests are not specific enough.